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Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF.

Publication ,  Journal Article
DeVore, AD; Hellkamp, AS; Becker, RC; Berkowitz, SD; Breithardt, G; Hacke, W; Halperin, JL; Hankey, GJ; Mahaffey, KW; Nessel, CC; Singer, DE ...
Published in: Europace
August 2016

AIMS: The high costs associated with treatment for atrial fibrillation (AF) are primarily due to hospital care, but there are limited data to understand the reasons for and predictors of hospitalization in patients with AF. METHODS AND RESULTS: The ROCKET AF trial compared rivaroxaban with warfarin for stroke prophylaxis in AF. We described the frequency of and reasons for hospitalization during study follow-up and utilized Cox proportional hazards models to assess for baseline characteristics associated with all-cause hospitalization. Of 14 171 patients, 14% were hospitalized at least once. Of 2614 total hospitalizations, 41% were cardiovascular including 4% for AF; of the remaining, 12% were for bleeding. Compared with patients not hospitalized, hospitalized patients were older (74 vs. 72 years), and more frequently had diabetes (46 vs. 39%), prior MI (23 vs. 16%), and paroxysmal AF (19 vs. 17%), but less frequently had prior transient ischaemic attack/stroke (49 vs. 56%). After multivariable adjustment, lung disease [hazard ratio (HR) 1.46, 95% confidence interval (CI) 1.29-1.66], diabetes [1.22, (1.11-1.34)], prior MI [1.27, (1.13-1.42)], and renal dysfunction [HR 1.07 per 5 unit GFR < 65 mL/min, (1.04-1.10)] were associated with increased hospitalization risk. Treatment assignment was not associated with differential rates of hospitalization. CONCLUSION: Nearly 1 in 7 of the moderate-to-high-risk patients with AF enrolled in this trial was hospitalized within 2 years, and both AF and bleeding were rare causes of hospitalization. Further research is needed to determine whether care pathways directed at comorbid conditions among AF patients could reduce the need for and costs associated with hospitalization.

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Published In

Europace

DOI

EISSN

1532-2092

Publication Date

August 2016

Volume

18

Issue

8

Start / End Page

1135 / 1142

Location

England

Related Subject Headings

  • Warfarin
  • Treatment Outcome
  • Stroke
  • Rivaroxaban
  • Risk Factors
  • Proportional Hazards Models
  • Multivariate Analysis
  • Male
  • International Cooperation
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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DeVore, A. D., Hellkamp, A. S., Becker, R. C., Berkowitz, S. D., Breithardt, G., Hacke, W., … ROCKET AF Steering Committee and Investigators, . (2016). Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF. Europace, 18(8), 1135–1142. https://doi.org/10.1093/europace/euv404
DeVore, Adam D., Anne S. Hellkamp, Richard C. Becker, Scott D. Berkowitz, Guenter Breithardt, Werner Hacke, Jonathan L. Halperin, et al. “Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF.Europace 18, no. 8 (August 2016): 1135–42. https://doi.org/10.1093/europace/euv404.
DeVore AD, Hellkamp AS, Becker RC, Berkowitz SD, Breithardt G, Hacke W, et al. Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF. Europace. 2016 Aug;18(8):1135–42.
DeVore, Adam D., et al. “Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF.Europace, vol. 18, no. 8, Aug. 2016, pp. 1135–42. Pubmed, doi:10.1093/europace/euv404.
DeVore AD, Hellkamp AS, Becker RC, Berkowitz SD, Breithardt G, Hacke W, Halperin JL, Hankey GJ, Mahaffey KW, Nessel CC, Singer DE, Fox KAA, Patel MR, Piccini JP, ROCKET AF Steering Committee and Investigators. Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF. Europace. 2016 Aug;18(8):1135–1142.
Journal cover image

Published In

Europace

DOI

EISSN

1532-2092

Publication Date

August 2016

Volume

18

Issue

8

Start / End Page

1135 / 1142

Location

England

Related Subject Headings

  • Warfarin
  • Treatment Outcome
  • Stroke
  • Rivaroxaban
  • Risk Factors
  • Proportional Hazards Models
  • Multivariate Analysis
  • Male
  • International Cooperation
  • Humans